THIRATH MARK LUONG (PA-C) – Physician Assistant, NPI 1629304654
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,031 PHYSICIAN ASSISTANT in MN
Provider Addresses for THIRATH MARK LUONG (PA-C)
Commerce Drive, Woodbury, Washington County, Minnesota, 55129, United States
WOODBURY, MN 551254925
Phone: (651) 968-5200
Type: Mailing
17210 KENYON AVE
LAKEVILLE, MN 550446903
Phone: (651) 968-5201
Fax: (651) 968-5903
Type: Location
Eagan Woods Drive, Eagan, Dakota County, Minnesota, 55121, United States
EAGAN, MN 551211138
Phone: (651) 968-5230
Fax: (651) 968-5200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-06-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110915000624 | I | Physician Assistant | MN | TBD |
| I20210622003723 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 61 | 27 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 45 | 45 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 29 | 28 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 17 | 17 | $0 |
| 73564 | X-ray of knee, 4 or more views | 15 | 15 | $0 |
Insurance plans in this area (ZIP 55125)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | MN | |
| Orthopedic Surgery, Sports Medicine | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN |
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